疫苗接种与儿童免疫球蛋白A血管炎发病风险的关联

Association between vaccination and the risk of immunoglobulin A vasculitis in children

摘要:

目的 探究疫苗接种对儿童免疫球蛋白A血管炎（immunoglobulin A vasculitis, IgAV）短期发病风险的影响。方法 回顾性分析2021年11月—2023年1月郑州大学附属儿童医院住院治疗的IgAV患儿一般资料及发病前1年内疫苗接种史。通过自身对照-病例交叉分析方法，比较IgAV发病前3个月风险期和对照期的疫苗暴露率，计算比值比（odds ratio, OR）和95%置信区间（confidence interval, CI），同时进行1个月、2个月风险期的敏感性分析。结果 纳入193例IgAV患儿，中位年龄为7.0岁；36例（18.7%）在发病前1年内至少接种1次疫苗，14例（7.3%）在3个月风险期至少接种1次疫苗。与未接种疫苗组相比，接种疫苗组IgAV发病年龄更小，差异有统计学意义（P<0.05）。两组胃肠道受累、肾脏受累、关节受累患儿比例的比较差异无统计学意义（P>0.05）。发病前3个月内接种任意种类疫苗与IgAV发病风险的OR值为2.08（95%CI：0.82~5.27，P>0.05）。进一步对1个月、2个月风险期进行敏感性分析，显示接种任意种类疫苗与IgAV发病风险的OR值分别为2.74（95%CI：0.72~10.48）、2.72（95%CI：0.95~7.77），均无统计学意义（P>0.05）。结论 疫苗接种未增加儿童IgAV发病风险，也未使IgAV患儿临床症状加重。

Abstract:

Objective To study the effect of vaccination on the short-term risk of immunoglobulin A vasculitis (IgAV) in children.Methods A retrospective analysis was conducted on the general data and the vaccination history within one year prior to onset in children with IgAV hospitalized in the Children's Hospital Affiliated to Zhengzhou University from November 2021 to January 2023. Vaccine exposure rates in the risk period (3 months prior to IgAV onset) and the control period were compared by autocontrol-case crossover analysis, and the odds ratio and 95% confidence interval (95%CI) were calculated. A sensitivity analysis for the one-month and two-month risk periods was conducted.Results A total of 193 children with IgAV were included, with a median age of 7.0 years. Among the 193 children, 36 (18.7%) received at least one dose of the vaccine within 1 year prior to IgAV onset, and 14 (7.3%) received at least one dose of the vaccine during the 3-month risk period. Compared to the unvaccinated IgAV group, the vaccinated IgAV group had a significantly younger age of onset (P<0.05). There were no significant differences in the proportions of children with gastrointestinal involvement, renal involvement, and joint involvement between the two groups (P>0.05). The odds ratio for developing IgAV after receiving any type of vaccine within 3 months prior to IgAV onset was 2.08 (95%CI: 0.82-5.27, P>0.05). Further sensitivity analysis for the 1-month and 2-month risk periods demonstrated that the odds ratios for developing IgAV after receiving any type of vaccine were 2.74 (95%CI: 0.72-10.48, P>0.05) and 2.72 (95%CI: 0.95-7.77, P>0.05), respectively.Conclusions Vaccination dose not increase the risk of IgAV, nor does it exacerbate clinical symptoms in children with IgAV.